How a healthCARING model can eliminate patient non-compliance

Over the past few years I have written a number of “patient non-compliance” pieces forHospital Impact, and apparently the posts have struck a chord with readers. Thomas Dahlborg

Today I am sharing brilliant feedback from a local healthcare leader and a story that highlights the impact to patients, families, communities and the costs of not improving the system to better address this challenge.
First the feedback.

After having read and reflecting on a 2014 Hospital Impactpost, “Lessons on Patient-centered care,” a local healthcare leader shared:


“Our patient partners suggested calling the concept ‘health capacity,’ and making it part of an ongoing assessment (i.e., conversation).

They said that we should look at each person and ask:

  • What is your capacity to do the work of your health today?
  • What resources do you have right now, to listen, ask questions, absorb, retain and then act?
  • What burdens do you have--responsibilities, needs, issues--that would take away from your capacity to do the work of your health?

It takes work for a provider or staff member to be present during the appointment. The same is true for patients. And if only we flipped that equation more often, supported staff better, we could all be more comfortable when we find ourselves in the other person’s shoes.”

Such wonderful and important feedback relative to true patient-centered care and the “non-compliant” patient.

Just consider the new paradigm:

  • Where we truly listen to our patient partners in the design process of an evolved care model (a healthCARING model)
  • Where we create a relationship-centered care model in which clinicians and staff are whole and healthy
  • Where these whole and healthy clinicians and staff are positioned to share their whole selves with their patients
  • Where patients feel safe to share their whole stories and where their whole stories are truly listened to and honored
  • Where the questions above are asked and patients who now have trust in their care team choose to share their truths
  • Where together clinicians and patients co-create a care pathway that leverages state-of-the-art clinical wisdom, medical research, patient preferences, and the information garnered through the sharing in this safe space and through the authentic and trusting relationship that is created in this new healthCARING model

That’s true innovation, better care and so much more...

  • Improved physician, nurse, and staff satisfaction, retention, engagement
  • Improved patient safety, engagement, experience, care pathway adherence
  • Better outcomes (and aligned with patient preferences)
  • Lower costs

Yes, healthCARING.

And here is what can happen in our current system of care. (A true story shared recently with me):

An African-American gentleman in his mid-fifties (Jim) is married and is blessed with four children (two living at home). He is slightly overweight and on medication to help manage his blood pressure. His wife lost her job recently, adding financial stress to the family. Jim soon thereafter was also laid off, thus multiplying the financial stressors. COBRA is offered, but Jim believes he cannot afford its cost.

Feeling it necessary to choose between feeding his family or paying for his medicine, he opts to stop taking his blood pressure medication.

One and a half months later, Jim experiences numbness and tingling in the right side of his face with facial drooping and loss of feeling and sensation on the left side of his body. Jim is rushed to the hospital and diagnosed with a cerebral vascular accident (CVA/stroke).

Jim did not believe there was a pathway within the healthcare system to support him and his healthcare as his socioeconomic condition changed.

Jim did not believe he had a trusting relationship with folks within the healthcare system to share the challenges he was now facing in his efforts to remain “compliant.”

Yes, the urgent care he received to address his stroke was excellent, and yet, Jim is now out of work, aphasic, beginning a long rehabilitation process, feeling a burden to his already stressed family, and costing the healthcare and safety-net system far beyond the cost of blood pressure medication.

It is time to transform the broken healthcare system to a healthCARING system for the benefit of all.

Thomas H. Dahlborg, M.S.H.S.M., is an industry voice for relationship-centered compassionate care and servant leadership. He is a keynote speaker, author, consultant and adviser and is the president of the Dahlborg Healthcare Leadership Group.